Professionals' experiences of supporting two-mother families in antenatal and child health care in Sweden.

BACKGROUND: In Sweden, antenatal and child health care are offered free of charge to all expectant and new parents. Professionals in antenatal and child health care play an important role in supporting parents. Previous research shows that same-sex mothers face heteronormative assumptions and insufficient support during their transition to parenthood. OBJECTIVE: To explore professionals' experiences of supporting two-mother families in antenatal and child health care. METHOD: A qualitative method with focus group discussions was used. An interview guide was followed, and the discussions were held online. The data was analysed according to inductive content analysis. SETTINGS AND PARTICIPANTS: The participants were midwives (n = 8) and nurses (n = 5) in antenatal and child health care from different parts of Sweden. Participants were recruited through the coordinating midwives and child health care nurses in the different regions. FINDINGS: One main category was identified: Striving to be open-minded in supporting same-sex mothers. Health care professionals described meeting well-prepared mothers, with an equal commitment between each other, and mothers on guard against heteronormative views. Professionals provided support through empowerment by creating a safe environment and aiming at providing equal support to all parents or tailored support to same-sex mothers. Mothers described handling challenges, as a balancing act to acknowledge both mothers. Struggling with documents and communication and a lack of information were other challenges to be handled. Professionals reflected on their own professional competence and expressed that knowledge acquired through education, experience and personal interest all contributed to their competence. CONCLUSIONS: Forms and documentation need to be updated to be gender neutral to be including to a variety of family constelleations. Health care professionals need time to reflect on norms and challenges to better support both mothers in a two-mother family.

Mothers in same-sex relationships-Striving for equal parenthood: A grounded theory study.

AIMS AND OBJECTIVES: To get a deeper understanding of how mothers in same-sex relationships think and reason about their parenthood in terms of gender equality, and how they experience early parental support from child healthcare professionals. BACKGROUND: There is an increasing amount of research on how women in same-sex relationships experience healthcare services when forming a family. Yet there is limited knowledge of what kind of early parental support these women may request. DESIGN: Grounded theory. Follows guidelines for qualitative research (COREQ). METHOD: Twenty women ranging from 25 to 42 years of age participated in semi-structured interviews. Data collection and analysis took place in parallel, as recommended in grounded theory methodology. RESULTS: The results are described by the core category Same-sex mothers request professional support to achieve equal parenthood, which includes five categories: (a) equality in everyday life, (b) diversity in mother and child attachment, (c) justification of the family structure, (d) ambivalent thoughts about their child's future and (e) a special need for networking and request for professional support. These findings provide a deeper understanding of how same-sex mothers experience their parenthood and the parental support that is offered. CONCLUSION: Child healthcare professionals need to be sensitive and recognise both mothers as equal parents and offer early parenting groups where two-mother families feel included and supported. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals need to be aware of diverse family formations and meet each parent as a unique individual without heteronormative assumptions. Same-sex mothers must be treated as equal parents and acknowledged as mothers. Healthcare professionals should offer inclusive and supportive parental groups to same-sex families. They should also inform and support nonbirth mothers about the possibility to breastfeed.

Mothers in Same-Sex Relationships Describe the Process of Forming a Family as a Stressful Journey in a Heteronormative World: A Swedish Grounded Theory Study.

Objectives The aim of this study was to gain insight into how women in same-sex relationships experience the process of forming a family through the use of assisted reproduction technique (ART), from planning the pregnancy to parenthood, and their experience of parental support from healthcare professionals. Methods The participants were 20 women in a same-sex relationship who had conceived through ART at a Swedish clinic. Semi-structured interviews including open questions about pregnancy, parenthood and support from healthcare professionals were conducted. The interviews were tape-recorded and transcribed verbatim. The data were analysed according to grounded theory. Results The core category, A stressful journey through a heteronormative world, emerged from the analysis, as did three subcategories: A journey fraught with difficulties and decisions; The nuclear family as the norm; and A need for psychological support. Same-sex parents expressed a need for more information about how to access ART in Sweden. Both the healthcare organization and treatment were perceived as heteronormative. In particular, these women lacked psychological support during the demanding process of utilizing a sperm donor to conceive. Conclusions for Practice Professionals in antenatal care should undergo mandatory cultural competency training to ensure cultural sensitivity and the provision of updated information, tailored brochures and early parental support for families with same-sex parents. All parents need guidance and support from competent, caring personnel throughout the entire process of forming a family.

Parents' experiences of their teenage children's parenthood: An interview study.

In this study, we described and analyzed parents' experiences of teenage parenthood and the provision of support to their teenage children who had recently have become parents. A qualitative method was used. In-depth interviews with 24 participants were conducted, all parents of teenage parents. Data were analyzed using content analysis; four themes and 11 subthemes were identified. The results show that parents' norms and values were strongly influenced by their religious beliefs. The participants had mixed emotions and reactions to their teenage children's parenthood. Also participants were sources of support to the teenage parents and assisted them in their transition to parenthood. However, the participants also expressed the importance that their teenage children continue their education and avoid repeated pregnancies. This study highlights how emotional, instrumental, and informational support provided by parents to their teenagers can assist the latter in their transition to parenthood. In their work with teenage parents, healthcare providers can benefit from teenage parent's own parents involvement and experiences.

Pornography consumption among adolescent girls in Sweden.

OBJECTIVES: The aims of this study were to describe patterns of pornography consumption, investigate differences between consumers and non-consumers of pornography regarding sexual experiences, health and lifestyle and determine associations between pornography consumption and sexual experiences, health and lifestyle among adolescent girls. The hypotheses were that adolescent girls categorised as pornography consumers would report sexual experiences to a greater extent, and a riskier lifestyle and poorer health, compared with non-consumers. METHODS: A classroom survey was conducted among 16-year-old girls (N = 393). RESULTS: One-third (30%) consumed pornography. In this group, almost half (43%) had fantasies about trying to copy sexual acts seen in pornography and 39% had tried to copy sexual activities seen in pornography. A higher proportion of pornography-consuming girls reported sexual experiences compared with peers. A third (30%) reported experience of anal sex compared with 15% among non-consuming peers (p = 0.001). Furthermore, peer-relationship problems (17% vs 9%; p = 0.015), use of alcohol (85% vs 69%; p = 0.001) and daily smoking (27% vs 14%; p = 0.002) were reported to a greater extent than in non-consuming peers. Pornography consumption, use of alcohol and daily smoking were associated with experience of casual sex. CONCLUSIONS: Pornography-consuming girls reported sexual experiences and a risky lifestyle to a greater extent compared with non-consuming girls. This indicates that pornography consumption may influence sexualisation and lifestyle. This is important to acknowledge when designing and implementing sexual health programmes for adolescents.

The voice of non-pregnant women on alcohol consumption during pregnancy: a focus group study among women in Sweden.

BACKGROUND: Consensus is that fetal exposure to alcohol is harmful. Abstinence while trying to conceive and throughout pregnancy is recommended. Despite this, there are many women who consume alcohol around conception and until pregnancy recognition. The aim of this study was to explore the voice of non-pregnant women concerning alcohol consumption and its relation to pregnancy. METHODS: Data were collected through seven focus groups interviews with 34 women of fertile age, who were neither pregnant nor mothers. Semi-structured interviews were undertaken, recorded and transcribed verbatim and then analysed using thematic analysis. RESULTS: Three main themes were identified in the analysis: an issue that cannot be ignored; awareness and uncertainty concerning alcohol and pregnancy; and transition to parenthood. Alcohol was an integral part of the women's lives. A societal expectation to drink alcohol was prevalent and the women used different strategies to handle this expectation. Most women agreed not to drink alcohol during pregnancy although their knowledge on the specific consequences was scanty and they expressed a need for more information. Most of the participants found drinking alcohol during pregnancy to be irresponsible and saw pregnancy as a start of a new way of life. CONCLUSIONS: Social expectations concerning women's alcohol use change with pregnancy when women are suddenly expected to abstain. Although most study participants shared an opinion for zero tolerance during pregnancy, their knowledge regarding consequences of drinking during pregnancy were sparse. In order for prospective mothers to make informed choices, there is a need for public health initiatives providing information on the relationship between alcohol consumption and reproduction.

Father role: A comparison between teenage and adult first-time fathers in Thailand.

In this study, we compared perceived father roles among teenage and adult first-time fathers in Thailand. The design was cross-sectional and comparative, and the sample involved 70 teenage and 70 adult fathers, whose children were 2-6 months old. The fathers were recruited from 32 primary healthcare centers in the western region of Thailand. Three validated, self-reported questionnaires with multiple-choice questions were used for data collection. Differences between the two groups were analyzed using χ(2)-test and the Mann-Whitney U-test. The results revealed differences between teenage and adult fathers concerning income, educational level, and intention to have a baby. The teenage father group had a lower sense of competence, and scored lower on childrearing behavior and father-child relationship than the adult father group. These findings provide healthcare professionals with increased knowledge and understanding of teenage fathers' needs in preparing for parenthood. Given that we now know the importance of positive father roles in children's lives, health authorities should be expected to provide resources to help support these fathers.

Professionals' perceptions of the effect of pornography on Swedish adolescents.

OBJECTIVE: The aims were to gain a deeper understanding of how personnel, who work with adolescents, reason about the effect of pornography and its spread in the media, and to explore how well prepared they consider themselves to be in addressing sexual health and gender equality. DESIGN AND SAMPLE: An inductive, exploratory, qualitative study with focus group discussions was selected. Seventeen participants with different professions were invited into five heterogeneous groups. MEASURES: Data were analyzed according to grounded theory. RESULTS: Conflicting messages about sexuality became the core category. Participants were of the opinion that pornography conveyed a contradictory message compared with national public health goals, societal laws, and regulations. They believed that young people use pornography as a source of information and stimulation. Furthermore, they thought that pornography contributed to norm-creating ideals and a demanding sexuality, thus, confirming the traditional gender order. The participants opined that a professional approach was required when addressing sexuality and gender equality issues and requested better training tools and more cultural competence. CONCLUSIONS: Professionals working with adolescents perceived that pornography conveys a conflicting message about sexuality. They expressed a need for adequate tools for improving education on health and sexuality, including gender equality aspects and critical media analysis.

Sexual experiences in relation to HPV vaccination status in female high school students in Sweden.

OBJECTIVES: To investigate sexual experiences, sexually transmitted infections (STIs) and use of condoms in relation to human papillomavirus (HPV)-vaccination status in female high school students. METHODS: In 2013, 355 female students with a median age of 18 years from randomly selected high schools in Sweden answered a classroom questionnaire on sexual experiences and HPV-vaccination status. RESULTS: In total 227/348 (65%) of the women reported having received at least one HPV vaccine dose. Median age at first intercourse was 15 and 16 years respectively, in the 141/227 (62%) vaccinated after, and the 86/227 (38%) vaccinated before their sexual debut. There were no differences between the HPV-vaccinated and non-vaccinated groups regarding condom use, STIs, and experiences of oral and anal sex, or friends- with-benefit relationships. However, having had sexual intercourse and 'one-night stands' were more common in the vaccinated group (both p < 0.05). CONCLUSION: Many students (62%) were vaccinated against HPV, with two-thirds after their sexual debut. There were no differences in condom use and STIs, and only a few differences in sexual experiences between the HPV-vaccinated and non-vaccinated groups. Initiating HPV vaccination before sexual debut is important, as is information about the link between HPV, sexual behaviour and cancer.

Prevalence of alcohol use before and during pregnancy and predictors of drinking during pregnancy: a cross sectional study in Sweden.

BACKGROUND: There is a paucity of research on predictors for drinking during pregnancy among women in Sweden and reported prevalence rates differ considerably between studies conducted at different antenatal care centres. Since this knowledge is relevant for preventive work the aim of this study was to investigate these issues using a multicenter approach. METHODS: The study was conducted at 30 antenatal care centers across Sweden from November 2009 to December 2010. All women in pregnancy week 18 or more with a scheduled visit were asked to participate in the study. The questionnaire included questions on sociodemographic data, alcohol consumption prior to and during the pregnancy, tobacco use before and during pregnancy, and social support. RESULTS: Questionnaires from 1594 women were included in the study. A majority, 84%, of the women reported alcohol consumption the year prior to pregnancy; about 14% were categorized as having hazardous consumption, here defined as a weekly consumption of > 9 standard drinks containing 12 grams of pure alcohol or drinking more than 4 standard drinks at the same occasion. Approximately 6% of the women consumed alcohol at least once after pregnancy recognition, of which 92% never drank more than 1 standard drink at a time. Of the women who were hazardous drinkers before pregnancy, 19% reduced their alcohol consumption when planning their pregnancy compared with 33% of the women with moderate alcohol consumption prior to pregnancy. Factors predicting alcohol consumption during pregnancy were older age, living in a large city, using tobacco during pregnancy, lower score for social support, stronger alcohol habit before pregnancy and higher score for social drinking motives. CONCLUSIONS: The prevalence of drinking during pregnancy is relatively low in Sweden. However, 84% of the women report drinking in the year preceding pregnancy and most of these women continue to drink until pregnancy recognition, which means that they might have consumed alcohol in early pregnancy. Six factors were found to predict alcohol consumption during pregnancy. These factors should be addressed in the work to prevent alcohol-exposed pregnancies.

Qualitative interviews with adolescents about "friends-with-benefits" relationships.

OBJECTIVE: To describe the thoughts, reflections, and experiences of friends-with-benefits relationships among a group of Swedish adolescents. DESIGN AND SAMPLE: A qualitative study with an explorative and descriptive design. Eight adolescents, aged 16-18, were interviewed. MEASURES: Individual in-depth interviews were undertaken. Data were analyzed using latent content analysis. RESULTS: The informants involved themselves in Friends-with-benefits (FWB) relationships to find physical and psychological intimacy without any expectations or demands. FWB relationships were perceived to have more advantages when the partner was a close friend with whom an informant felt comfortable. There was ambivalence about the legitimacy of romantic feelings in an FWB relationship, although it was quite common. Sexual concurrency was common and often accepted. Sexual risk-taking behavior involving the use of alcohol and a lack of contraception was considered common in FWB relationships. Informants requested more education and support as regards their sexual behavior. CONCLUSIONS: FWB relationships were often initiated to find physical and psychological intimacy with no expectations or demands. Advantages such as sexual concurrency and no demands were central. A deeper understanding of how adolescents think and reason about sexuality and relationships can make a difference when working to improve young people's sexual and reproductive health.

Hercules and Barbie? Reflections on the influence of pornography and its spread in the media and society in groups of adolescents in Sweden.

OBJECTIVES: To describe and get a deeper understanding of how groups of young women and men reflect on and discuss pornography and its spread in the media and society, and its possible influence on sexual behaviour and relationships. METHODS: Six focus group interviews were conducted with teenagers, three with women (n = 17) and three with men (n = 18). Open questions about pornography and its spread in the media and society were discussed. The interviews were tape-recorded and transcribed verbatim. Data were analysed according to Grounded Theory. RESULTS: The core category 'A discriminatory sexuality' illustrates how participants felt regarding the messages conveyed by pornography portraying a man's role as dominant and a woman's role as subordinate. Pornographic messages were described as 'Fiction' depicting a distorted reality. Feelings of ambivalence towards pornography were expressed: anxiety and fear, but also inspiration. Participants said pornography occurred everywhere in the media and society, and felt pressured by messages relating to looks and sexual techniques. CONCLUSIONS: Pornography and its spread in the media and society were considered as presenting a discriminatory image of body ideals, sexuality and relationships. Despite this awareness, both men and women considered pornography as sources of knowledge and inspiration: an apparent paradox.

Associations between heteronormative information, parental support and stress among same-sex mothers in Sweden-A web survey.

AIM: The aim was to investigate same-sex mothers' self-assessed experiences of forming a family, and the association between heteronormative information, parental support and parenting stress. DESIGN: A quantitative, cross-sectional study. METHODS: In a web survey conducted in Sweden in 2019, same-sex mothers (N = 146) with a child aged 1-3 years answered questions about their experiences of forming a family through assisted reproduction and questions about parenting stress. Descriptive statistics describes the process of forming a family. Pearson's correlation analyses and independent sample t tests were used to test hypotheses about heteronormative information, parental support and parenting stress. RESULTS: Same-sex mothers experienced going through assisted reproduction treatment as stressful, and parental groups as not being supportive. Heteronormative information correlated with both lower perceived parental support and higher perceived parenting stress. Non-birth mothers experienced less acknowledgement and support than birthmothers.

Sexual behaviour and contraceptive use among Swedish high school students in two cities: comparisons between genders, study programmes, and over time.

OBJECTIVES: To investigate sexual behaviour and contraceptive use among first-year high school students in two Swedish cities in 2009, to compare male and female students, students in theoretical and vocational study programmes, and their sexual behaviour with that reported in 1979, 1989 and 1999. METHODS: In a cluster sample of 20 classes, students (N = 387), median age 16 years, completed a questionnaire consisting of 46 questions. RESULTS: More girls than boys had experienced petting (p ≤ 0.003) and had received oral sex (p ≤ 0.01). More boys than girls had masturbated (p ≤ 0.0001) and watched pornography (p ≤ 0.0001). The median age at first sexual intercourse was 15 years. Students in vocational programmes were more sexually experienced compared to their theoretical peers. The proportion of students having had sexual intercourse (p ≤ 0.0002), and contraceptive use at first (p ≤ 0.0001) and latest (p ≤ 0.0001) sexual intercourse increased from 1979 to 2009. Alcohol use at first intercourse decreased over the period (p ≤ 0.0001). CONCLUSIONS: Girls were more sexually experienced than boys, as were students in vocational programmes compared to their theoretical peers; this should be considered when tailoring sex education and counselling. Over time, an increase in students having had sexual intercourse, and contraceptive use at first and latest sexual intercourse was found.

Changes in sexual behavior among high-school students over a 40-year period.

The aim of this study was to investigate sexual behavior, contraceptive use, risk factors as well as sources of sex information among first-year high-school students in Sweden. Secondly, to assess differences between genders and study programs as well as changes over a 40-year period. A repeated cross-sectional survey was conducted in two cities. A questionnaire comprising 77 items was used. The study population consisted of 415 students (63.4% females). The median age of sexual intercourse was 15 years. In total, 37% had had sexual intercourse, compared to 56.3% in 2009 and 45% in 1999 (p < 0.001), and the proportion of students who had their first sexual intercourse was not influenced by gender. More students in vocational programs (46.3%), compared to theoretical (33.3%), had experience of at least one sexual intercourse (p = 0.019). The same extend of contraception use at first and latest intercourse was reported, compared to previous studies. Forty-nine percent were mostly informed about sex from the internet, while in previous years, magazines, family and youth clinics were the main information sources. Comparing over time, students were in general less sexually experienced and less engaged in non-penetrative sex and physical intimacy. These findings call for a new approach, when designing sex and relationship education and health-care counseling in adolescents.

Experiences of and attitudes towards pornography among a group of Swedish high school students.

OBJECTIVES: To investigate consumption of and attitudes toward pornography in relation to demographic factors and relationships to parents among third-year high school students. METHODS: A random sample of 718 students with a mean age 18 years (range 17-21) completed a classroom questionnaire consisting of 89 questions. RESULTS: More students in practical than in theoretical study programmes had parents with a practical profession (p < 0.001). More parents to students attending theoretical programmes owned their housing (p < 0.001). More men than women had ever consumed pornography (98% vs. 72%; p < 0.001). More practical than theoretical students were influenced by watching pornographic films, fantasizing about (p < 0.05) or having performed acts inspired by pornography (p < 0.05). Both theoretical and practical male students had more favourable attitudes toward pornography than either group of female students (p < 0.001; p = 0.037). More female, than male students, were of the opinion that pornography could create uncertainty and demands. CONCLUSION: Students' high school programme choices partly reflect their social background. Pornography was consumed mainly by male students, who also had the most favourable attitudes, while females mainly had negative attitudes. To promote sexual health these differences between genders and study programmes should be taken into consideration in counselling, and in sex- and relationships education.

The New Generation of Thai Fathers: Breadwinners Involved in Parenting.

Becoming a father for the first time might cause great changes in a man's identity and lifestyle. Teenage fathers must strive to balance two competing roles: the teenage role and the father role. The current study design followed grounded theory methodology to gain a deeper understanding of how Thai teenage fathers reason about becoming and being a father from a gender equality perspective. Participants were selected from a heterogeneous group of fathers until saturation was reached ( n = 25). Most of the fathers were cohabiting with their partner in an extended family. An interview guide was developed, a pilot study was undertaken, and interviews were performed on two different occasions: once during the second trimester of pregnancy and again when the baby was 5 to 6 months old. The core category, "Male breadwinners involved in parenting," encompassed persons making the transition from being solely a teenager to being a teenage father. Most of the fathers accepted the unintended pregnancy and took on the expected breadwinning responsibility of a father. They prepared for fatherhood and changed their lifestyle. Their families provided support. Nevertheless, the fathers sought to avoid further unplanned parenthood by learning about family planning. The teenage fathers emphasized breadwinning first, then involved himself in the child and the housework. These findings provide an increased understanding of Thai teenage fathers.

Pornography consumption and psychosomatic and depressive symptoms among Swedish adolescents: a longitudinal study.

BACKGROUND: The aims of this longitudinal study were to identify predictors for continued pornography consumption and to investigate pornography consumption in relation to psychosomatic and depressive symptoms among a group of adolescents in Sweden. METHODS AND MATERIALS: A longitudinal study in classroom environment in 53 randomly selected senior high school classes in mid-Sweden in years 2011 and 2013. Out of 477 participating boys and 400 girls in 2011, 224 boys (47%) and 238 girls (60%) participated in 2013. RESULTS: Higher pornography consumption at baseline and being born outside Sweden predicted continued pornography consumption at follow-up (adjusted R2 = 0.689). Psychosomatic symptoms at follow-up were predicted by higher pornography consumption at baseline (adjusted R2 = 0.254), being a girl, living with separated parents, and attending a vocational high school program. By contrast, depressive symptoms at follow-up were predicted by less pornography consumption at baseline (adjusted R2 = 0.122) and being a girl. CONCLUSIONS: Pornography consumption may, for some individuals, be associated to mental health issues. Differences between teenage boys and girls and between adolescents with diverse ethnic backgrounds imply that counseling and discussion about pornography need to be adjusted and individualized.

Struggling with motherhood and coping with fatherhood - A grounded theory study among Thai teenagers.

OBJECTIVE: to gain a deeper understanding of Thai teenage parents' perspectives, experiences and reasoning about becoming and being a teenage parent from a gender perspective. DESIGN: an exploratory design using grounded theory methodology. Semi-structured interviews were used to collect data. An interview guide was developed, a pilot study was undertaken, and interviews were performed on two different occasions: once during the second trimester of pregnancy and again when the infant was 5-6 months old. SETTING: a province in the western part of Thailand. PARTICIPANTS: the selection of a heterogeneous group of teenage parents-to-be continued until saturation was reached, as describe by Glaser and Strauss (1967), in all n=50. Inclusion criteria for participants were that they were heterosexual couples, under 20 years of age, cohabiting, and expecting their first child. FINDINGS: the core category 'struggling with motherhood and coping with fatherhood' comprises descriptions of the process from when the teenagers first learned about the pregnancy until the child was six months old. The teenagers had failed to use contraceptives which led to an unintended parenthood. Their parenthood became a turning point as the teenagers started to change their behaviours and lifestyle during pregnancy, and adapted their relationships to partner and family. Family commitments was a facilitator, through support given by their families. Finally, becoming a parent describes ways of dealing with the parental role, by engaging in parental activities and reestablishing goals in life. Most of the teenage parents reproduced traditional gender roles by being a caring mother or a breadwinning father respectively. KEY CONCLUSIONS: 'struggling with motherhood and coping with fatherhood' referred to the parents' stories about how they struggled and coped with life changes and their parental role when they became unintentionally pregnant, accepted their parenting, and finally became parents. After becoming parents, the main concerns of most of the teenage parents were being a caring mother and a breadwinning father. IMPLICATIONS FOR PRACTICE: this study contributes a deeper understanding of Thai teenage parents' experiences of becoming and being a parent and might improve health care professionals' adaptation of care for teentranatanage parents and inspire them to tailor their care specifically to teenager's needs from early pregnancy to parenthood.

Sex behavior among high school students in Sweden: improvement in contraceptive use over time.

PURPOSE: To investigate sexual behavior and attitudes toward sexuality among first-year high school students in Sweden in 1999 and to compare the sexual behavior with that reported from similar studies in 1979 and 1989. METHODS: In Spring 1999, a questionnaire with 47 questions mainly of multiple-choice nature was administered to a random sample of 20 classes in senior high school in two medium-sized cities in Sweden. The median age of the students was 16 years. Differences in sexual behavior and attitudes were evaluated with the Chi-square and Student's t-test. RESULTS: Almost half of the students (46%) had had intercourse, showing that the age of coitarche had not decreased during the past two decades. The median age at intercourse of those who had had intercourse was 15 years in both genders. More students in practical (vocational-technical) programs (60%) than in theoretical (college preparatory) ones (37%) had had sexual intercourse. More teenagers in theoretical (90%) than in practical programs (64%) had used contraceptives at their first intercourse, an increase from 65% in 1979 to 76% in 1999. One-fourth of the teenagers were under the influence of alcohol at the first intercourse, a decrease, compared with 1979. CONCLUSIONS: Contraceptive use at coitarche has increased and alcohol use decreased over the 20-year-period. The tendency noted 10 years ago that students attending practical programs put themselves at more health risk than students in theoretical programs continues. This fact should be considered when planning for counseling and sex education.